Diabetes Metab J.  2011 Oct;35(5):529-535. 10.4093/dmj.2011.35.5.529.

Comparison of Vildagliptin-Metformin and Glimepiride-Metformin Treatments in Type 2 Diabetic Patients

• Jeon HJ
• Oh TK

• KMID: 1857509
• DOI: http://doi.org/10.4093/dmj.2011.35.5.529

Abstract

BACKGROUND
The present study investigated the efficacy and safety of vildagliptin-metformin treatment compared to those of glimepiride-metformin treatment for type 2 diabetes.
METHODS
In a randomized, open-label, comparative study, 106 patients with type 2 diabetes were enrolled. The primary endpoint was a reduction in HbA1c from baseline and secondary endpoints included fasting plasma glucose (FPG) or 2-hour postprandial glucose (2h-PPG) reduction from baseline, as well as HbA1c responder rate and HbA1c reduction according to baseline HbA1c category.
RESULTS
Comparable HbA1c reduction was observed with a mean+/-standard deviation change from baseline to the 32-week endpoint of -0.94+/-1.15% in the vildagliptin group and -1.00+/-1.32% in the glimepiride group. A similar reduction in 2h-PPG (vildagliptin group 3.53+/-4.11 mmol/L vs. the glimepiride group 3.72+/-4.17 mmol/L) was demonstrated, and the decrements in FPG (vildagliptin group 1.54+/-2.41 mmol/L vs. glimepiride group 2.16+/-2.51 mmol/L) were not different between groups. The proportion of patients who achieved an HbA1c less than 7% at week 32 was 50.1% in the vildagliptin group and 56.0% in the glimepiride group. An average body weight gain of 2.53+/-1.21 kg in the glimepiride group was observed in contrast with the 0.23+/-0.69 kg weight gain noted in the vildagliptin group. A 10-fold lower incidence of hypoglycemia was demonstrated in the vildagliptin group, in addition to an absence of severe hypoglycemia.
CONCLUSION
Vildagliptin-metformin treatment provided blood glucose control efficacy comparable to that of glimepiride-metformin treatment and resulted in better adverse event profiles with lower risks of hypoglycemia and weight gain.

Keyword

Diabetes mellitus, type 2; Glimepiride; Metformin; Vildagliptin

MeSH Terms

Adamantane
Blood Glucose
Body Weight
Diabetes Mellitus, Type 2
Fasting
Glucose
Humans
Hypoglycemia
Incidence
Metformin
Nitriles
Plasma
Pyrrolidines
Sulfonylurea Compounds
Weight Gain
Adamantane
Blood Glucose
Glucose
Metformin
Nitriles
Pyrrolidines
Sulfonylurea Compounds

Figure

• 

  Fig. 1 (A) Mean fasting plasma glucose (FPG) and 2-hour post-prandial glucose (2h-PPG) reduction in vildagliptin or glimepiride treatment. (B) Decrement of HbA1c on the week 32 end-point in vildagliptin or glimepiride treatment. (C) Mean HbA1c changes during 32 weeks in vildagliptin or glimepiride treatment.

• 

  Fig. 2 Mean HbA1c reduction according to the baseline HbA1c category.

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